How D-ATM Works

On this page:

How D-ATM Works
Use of D-ATM in an OTP
Benefits of D-ATM

How D-ATM Works

Digital Access to Medication (D-ATM) acts as a central repository and sends a selected set of opioid addiction treatment-related data. Opioid Treatment Programs (OTPs) communicate with the database in an automated fashion. On a daily basis, participating programs will automatically send a limited, but core, data set to D-ATM, thereby ensuring that information is timely. This is accomplished through the Application Program Interface (API).

In turn, an OTP may access the needed data if it becomes necessary to provide treatment (as a "guest OTP") to a patient who usually obtains treatment at a different facility (their "home OTP").

Patient privacy and personal information security are of the highest priority in this project, and they are key design elements of D-ATM. Security of patient information is ensured through the following:

Maintaining the least data necessary—D-ATM stores only a medicine order and a record of recent dosing events. The medicine order indicates which medication is being taken and its upcoming dosage schedule.

Graphic of a finger scan showing minutiae.

Using a biometric identifier—D-ATM correlates the medicine orders with an identifier randomly generated via an algorithm applied to a biometric measure (in this case, data points referred to as "minutiae" are calculated based on the scan of a patient's finger). The system does not include any information directly connecting it to any specific patient (e.g., patient names or social security numbers).

D-ATM records are set up in a way that prevents outside parties from associating information in the system with a specific individual. To associate the records to the proper individual, the individual's finger needs to be scanned, and the proprietary algorithm must be matched up with the finger scan's minutiae. D-ATM does not keep any copies of finger scan images, and processing is done in real-time with no residual storage of images. Only then can the random identifier be called up and associated with the maintained medical data stored by the system.

Use of D-ATM in an OTP

Patient participation in D-ATM is voluntary and is not required for continued treatment. If a patient chooses to participate, he or she will need to go through a brief, one-time enrollment. The following procedures will be followed:

The patient reads and signs the D-ATM Consent and Release Form. This form explains the system and the legal protections afforded to their medical information.
The patient has his or her finger scanned.
The system captures the finger scan minutiae.
The system applies the proprietary algorithm to the minutiae.

The system generates a patient identifier number to be associated with the patient's minutiae, medicine order, and dosing records.

This is the enrollment process. Later, if a patient needs to seek treatment at a "guest" OTP, he or she will be asked to scan his or her finger again.

Patient data can only be accessed with the patient's approval.

From the perspective of OTP staff, D-ATM has been designed so that it places minimum burden on staff. For the pilot, D-ATM is being designed to integrate with several medical recordkeeping systems already in use by many OTPs.

For OTP staff currently using an online, recordkeeping system, there will be almost no additional information gathering or data entry, as D-ATM is being developed to work seamlessly with the existing medical record system.
For OTP staff working outside of a medical record system tied to D-ATM, the recordkeeping demands are still minimal.

In either setting, the most time-consuming activity will be the patient's initial enrollment. This will generally take less than 1 minute per patient. "Guest" visits that occur during a disaster or other service disruption will consist of little more than taking a finger scan and retrieving the patient's medicine order and recent dosing history.

Benefits of D-ATM

If a patient needs to find treatment at a program other than their usual OTP, D-ATM will enable staff at the guest OTP to verify that the individual is a current patient in approved medical treatment for opioid addiction and to automatically access the patient's necessary medicine and dosage information.

Additionally, a guest program accessing D-ATM will be able to:

Determine when the patient is due for medication
Ascertain which treatment is due
Automatically notify the home clinic that treatment was administered to a guest patient

These benefits are packaged in an easy-to-use, automated fashion relying on no more than a quick finger scan.